The Sault Star column - September 1, 2009

2009-09-02

Integrating Technology Into Clinical Practice by MaryLou Bernardo

There are 422 million prescriptions dispensed in Canada every year!

It's also estimated that 400,000 Ontarians suffer a preventable reaction to medication.

'Medication management' to improve patient safety and reduce medication errors, is one of several key priorities of Ontario's Ministry of Health and Long-term Care (MOHLTC) and eHealth Ontario.

Group Health Centre (GHC) is one of only two sites in Ontario selected to participate in what was introduced as a groundbreaking eprescribing demonstration project. It's actually the first project of its kind in Canada.

Following great success and overwhelming support from participants, the eprescribing demonstration project wrapped up in June 2009 and has since been extended for an additional six months ending December 31st, 2009.

In order to continue the project, GHC's eprescribing project team formally asked eHealth Ontario and the regulatory colleges involved: the College of Physicians and Surgeons of Ontario, College of Nurses of Ontario and the College of Pharmacists, to extend their support of electronic prescribing at the GHC.

Lucy Fronzi, eprescribing project manager at the GHC says, "eHealth Ontario and the regulatory colleges extended their support of electronic prescribing at both GHC and the Georgian Bay family health team based in Collingwood, ON (and the only other eprescribing site)."

'Electronic prescribing' otherwise known eprescribing involves your physician or nurse practitioner using his or her computer to electronically generate, authorize (sign) and transmit prescriptions through secure system to pharmacists and other dispensers.

Instead of filling out a prescription on a notepad, a physician can complete a prescription in the patient's medical chart (electronic medical record {emr}) that contains their medical history.

A safety mechanism is in place to warn the provider if they prescribe unsafe drug combinations or a medication that a patient is allergic to. Once the physician or nurse practitioner fills out the prescription, a click of a mouse sends it to a pharmacist. Twenty-two pharmacies in Sault Ste. Marie are participating and pharmacists are able to view the patient's full treatment regimen. 

Presently, eprescribing is available to GHC patients who have a primary care provider (family physician with the Algoma District Medical Group or nurse practitioner) participating in the demo project. There are 16 family practitioners, five specialists and seven nurse practitioners at GHC participating. Patients have to first consent to eprescribing and they always have the choice to receive a paper prescription.

The benefits of eprescribing include:

~ less potential for dispensing errors resulting in fewer adverse drug reaction and unnecessary hospitalizations

~ forgoing illegible handwritten prescriptions. Pharmacists can easily read prescriptions, resulting in less waiting time.

~ improving access to your prescription and dispensing information.

Your prescription contains key information and directions, including: your name, dose, how to take it, when to take it, how long, where to store it, etc.

ePrescribing is  an integral part of Ontario's overall ehealth strategy. According to minister of health and long-term care, David Caplan,". Lessons learned from this program will be used to inform the implementation and adoption strategies for a province-wide eprescribing solution."

To prepare potential future sites interested in eprescribing initiatives, GHC and Health Tech consultants have developed an implementation tool kit. According to Fronzi, "The purpose of the toolkit is to tell the story of GHC's journey to integrate technology into clinical practice.

"GHC's journey and three key milestones are outlined in the toolkit: the adoption of an emr for use by the circle of care within the centre; the EMRxtra demonstration project that extended the 'circle of patient care' using the emr to community pharmacists and the implementation of eprescribing early adoption in an emr environment."

Fronzi adds, "The tool kit encompasses all aspects required to achieve successful clinical adoption of a comprehensive emr solution."

EMR was introduced at GHC in 1997 and has been described as the most significant change in the centre's history. The computerized system replaced thousands of paper charts that previously were manually prepared and filed.

What's next once the eprescribing demo project extension wraps up at the end of this year? Fronzi explains, "Additional support from the colleges will be contingent on the resolution of any significant regulatory issues, and on the continued support of eHealth Ontario."

Learn more about ehealth strategies, including plans to implement an electronic health record for all Ontarians by 2015, please visit: www.ehealthontario.on.ca

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MaryLou Bernardo is a Communications Coordinator with GHC's Patient Relations and Communication department. Email: bernardo_m@ghc.on.ca

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